FICCMD Application

Fellow of the Indian College of Cardio-Diabetology and Metabolic Disorders

Select Membership Status

Photo

Recent Photograph

Professional passport-size photo.
JPG or PNG (Max 2MB).

Council Reg

Council Registration

Certified copy of State or MCI Reg.
PDF Format only (Max 5MB).

Personal Information

Full Name of Nominee

Date of Birth

Email Address

Mobile Number

State

City

Postal Code

Full Correspondence Address

Qualifications

PG Degree (MD/DNB)

Year of Passing

University / Institution

Copy of Degree (PDF) *Required

Professional Achievements

Academic Experience

Research & Publications

Current Assignment

Social Welfare / Community Services

Nomination Support

Proposer Name

Membership No.

Seconder Name

Membership No.

I hereby declare that all the information provided in this application is true and correct to the best of my knowledge. I understand that any false statement may result in the rejection of my membership.

Current Selection

Fellow (New Applicant)

₹20,000

GSTIN10AADAC0958M1ZW

Eligibility Criteria

Minimum experience of 10 years after a Postgraduate degree of M.D./DNB in Internal Medicine/General Medicine from an institution or university recognised by the Medical Council of India/NMC.

Fellowship Enquiries

Dr. Mritunjay K Singh
Executive Secretary

Dr. Abhishek Kumar
Secretary

+91 9471660096